Philip Cooke, Purton Dental Practice, explains why Alminax Rite Bite is his bite registration material of choice
Despite the millions of pounds spent every year by dental manufacturers researching and developing, marketing and selling the latest developments in high quality impression materials, luting cements, crown and bridge materials, and technology – everything promising the most accurate fit and optimised aesthetics for the final crown and bridge restorations – bite registration remains one of the most important yet frequently neglected stages in crown and bridge work.
Providing your Technician with a correct and reliable bite registration is therefore one of the most time and cost saving factors in crown and bridge work.
There are lots of different options available to Practices looking for a reliable bite registration material, including various polyvinylsiloxane materials which deliver very dimensionally stable registrations but can be quite expensive. However there is not really any need to incur this cost because there are more cost effective but equally reliable wax based bite registration materials also available, including Kemdent’s Alminax range.
What makes Alminax the perfect wax bite registration material
To deliver a reliable and dimensionally stable wax bite registration you need a material specifically designed for the purpose. Simply warming up a piece of modelling wax, bending it into a horseshoe shape and asking the patient to bite down on it will not do.
To create an accurate and reliable wax bite registration requires a wax that enables the heat to spread uniformly throughout its volume, producing a consistency of softness so that the wax bite deforms evenly when placed within the mouth and it is bitten into. Generally materials used for bite registrations need to be stiffened or supported. If whole sheets of wax or sheets supported with metal plates are used the patients tongue can be disturbed leading to inaccurate registrations.
Investigations have shown that Alminax wax is the superior wax because it can absorb heat and soften quickly, it cools very easily and is very stable afterwards. Therefore it is the most suitable wax for bite indexes.
Alminax incorporates a conductive filler so that when it is warmed in the water bath, the heat is evenly spread throughout the thickness of the wax. Unlike conventional modelling wax which can have soft and firm parts, and does not necessarily deform evenly when it is bitten into.
Another advantage of Alminax bite registration wax is that is it thicker than normal modelling wax so it does not need to be folded in order to create a wax bite of adequate thickness. This folding frequently results in air bubbles becoming incorporated within the modelling wax bite. These air bubbles can expand and contract depending upon the temperature of the wax, resulting in distortion. What is more, if the patient happens to bite through an air bubble this results in loss of information at the contact points.
In addition, Alminax’s setting profile means that it remains robust ( stable and firm ) when removed from the mouth. This means it is harder than conventional modelling wax so it does not distort, leading to errors after it has been removed. Furthermore, it is more stable at a higher room temperature, for example within a hot Dental Laboratory, than normal modelling wax which means it is even less likely to become distorted.
Alminax bite registration wax is available in three presentations – sheets, Wax Full Arch and Rite Bite.
Alminax Wax Full Arch and Rite Bite are supplied in preformed U-shapes which mean that they do not need to be bent into shape, saving time. Compared with the simple sheet presentation, another advantage of these preshaped Alminax Wax Full Arch and Rite Bite options is that they feature a special cut away shape that allows adequate space for the tongue. Consequently there is no interference when the patient bites together, allowing the patient to bite comfortably in the correct position. The thickness of the Full Arch and Rite Bite wafers have been carefully selected too, so that they do not interfere with the soft tissues when recording the bite registration of a “normal” bite. Consequently they ensure that the plaster models do not hang on the wax when the models are articulated.
However I prefer the Rite Bite because it also incorporates a metal strip for enhanced accuracy and reliability.
Whichever option is chosen the manufacturers recommend that the wax bite is chilled in the mouth before removal in order to further reduce the risk of any hidden distortion. It should then be disinfected using an appropriate CE Marked Disinfectant ( for example Kemdent’s Practice Safe Soak ) before it is sent to the Laboratory.
Hints and Tips for success
Alminax Rite Bite wax wafers should be placed in a warm ( 55°C ) temperature controlled water bath for about 30 to 60 seconds so that they become uniformly softened throughout.
When prepared teeth are present a thicker layer of wax is required. Take an appropriately sized piece of one of the unstiffened wax wafers, supplied in the pack, and soften it in the water bath with the main index. Press the two pieces together and melt the edges together with a hot wax knife. Having different thicknesses of wax on the same bite registration does not matter because when it is reheated in the water bath it will have a uniform softness throughout. This is the most important part of a bite registration because it gives the patient the possibility to bite evenly and easily into the bite wax. If wax is just heated in a flame it does not soften uniformly and causes the registration to be inaccurate, like trying to chew a toffee in an up and down motion. The lower jaw will automatically move to the working side for the harder part.
When taking a registration adjust the warm index for length and width in the mouth. Alminax Rite Bite trims easily with scissors even through the reinforcement. Never adjust a cool index.
Replace the index in the controlled warm water bath to soften it evenly before placing it on the teeth in the largest arch in the mouth, normally the maxillary arch. Place the Alminax Rite Bite so that the outer edge follows the buccal line of the teeth. Try and keep it a little inside the outer cusp line because the wax will spread a little when the registration is made. If there is an overbite press the wax in the anterior region against the upper teeth with your finger to get a referring impression in this area as well.
Cool the index, but not too much, because now we come to the most crucial part. Take out the index and turn it over so that the smaller jaw side is visible. Cut the index along the line of the buccal cusps. If you see or suspect wax has gone up and pressed against soft tissues that wax must be cut away with a knife or scissors too.
It is always advisable to cut away wax distal to the last molar because soft tissue often goes up and onto this tooth and is compressed and distorted by the wax, possibly enough to disturb the registration when the models are mounted on the index prior to articulation.
Replace the index in the mouth and check the registration is perfect. If an index is completely cold and hard warm it up just a little in the warm water bath first. Once checked cool the index.
Remove index from mouth and pack it in a padded box for safe transport to the Laboratory.
Alminax Rite Bite is easy to handle, time saving and extremely accurate. It gives correct and reliable registrations virtually every time.
Both Dentists and Technicians find it easy to use and Technicians who’s Dentists use Alminax Rite Bite have no problems with adjustments or corrections.
Once you’ve tried it you won’t want to be without it.
Kemdent Alminax bite registration materials are manufactured in the UK by Associated Dental Products Ltd.
For further information contact Kemdent on 01793 770090 or Click Here
Hints and tips for success
|The Alminax Rite Bite Wafer.||Add some unstiffened wax wafer to|
the area of the prepared teeth.
|Soften the modified Rite Bite wafer |
in a warm water bath at 55°C.
|Trim the posterior area with scissors.|
Return the trimmed Rite Bite Wafer to
the water bath to soften it evenly.
|The Rite Bite wafer in situ.||Remove the Rite Bite wafer and |
cool it gently.
|The most crucial step, cut off the buccal|
and labial excess using scissors or a knife.
|Cut off the posterior excess in|
the retromolar area.
|The models correctly articulated using |
the trimmed Rite Bite wafer.